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Comment & Response |

Definitions of Tremor—Reply

W. Jeffrey Elias, MD1; Binit B. Shah, MD2
[+] Author Affiliations
1Department of Neurological Surgery, University of Virginia, Charlottesville
2Department of Neurology, University of Virginia, Charlottesville
JAMA. 2014;312(2):191-192. doi:10.1001/jama.2014.6231.
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In Reply Ideally, a definition of tremor should accurately include tremulous entities while excluding other nontremulous disorders.

We do not agree that irregular and rhythmic are mutually exclusive. Dystonic tremor has a rhythmicity but may be more irregular in terms of symmetry about a joint (eg, dystonic “no-no” head tremor may have a more prominent tremor in one direction, whereas an essential tremor should have a symmetrical head tremor) and can vary in amplitude or even presence based on positioning.


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July 9, 2014
Thomas E. Finucane, MD
1Division of Geriatric Medicine and Gerontology, Johns Hopkins Bayview Medical Center, Baltimore, Maryland
JAMA. 2014;312(2):191. doi:10.1001/jama.2014.6222.
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